Antibiotic Use and Subsequent Cognitive Decline and Dementia Risk in Healthy Older Adults.

Background And Objectives: Antibiotics rapidly reduce intestinal bacterial diversity, leading to dysbiosis that persists for months to years. Although emerging evidence from retrospective and claims-based studies has linked dysbiosis to cognitive function, prospective data are lacking. We aim to examine the prospective association of antibiotics with cognitive aging among initially healthy older adults.

2024 Update of the RECOVER-Adult Long COVID Research Index.

Importance: Classification of persons with long COVID (LC) or post-COVID-19 condition must encompass the complexity and heterogeneity of the condition. Iterative refinement of the classification index for research is needed to incorporate newly available data as the field rapidly evolves.

Objective: To update the 2023 research index for adults with LC using additional participant data from the Researching COVID to Enhance Recovery (RECOVER-Adult) study and an expanded symptom list based on input from patient communities.

Investigating Mechanisms Between Child Marriage, Intimate Partner Violence, and Psychological Distress in Malawi and Uganda: An Application of Generalized Structural Equation Models.

One in five women aged 20-24 years are first married before adulthood. Using the Violence against Children Surveys from Uganda and Malawi, we decomposed the total relationship between child marriage and psychological distress into an indirect relationship via intimate partner violence (IPV) and a direct relationship (above and beyond IPV). In Uganda, delaying marriage during adolescence reduced the probability of IPV and psychological distress in young adulthood; 45% of the total relationship between age at first marriage and psychological distress was mediated through IPV.

Evaluations of digital public health interventions in the WHO Southeast Asia Region: a systematic literature review.

Introduction: Digital health technologies have been enhancing the capacity of healthcare providers and, thereby, the delivery of targeted health services. The Southeast Asia Region (SEAR) has invested in strengthening digital public health. Many digital health interventions have been implemented in public health settings but are rarely assessed using the holistic health technology assessment (HTA) approach.

Urinary tartaric acid as a biomarker of wine consumption and cardiovascular risk: the PREDIMED trial.

Background And Aims: Moderate wine consumption has been associated with lower cardiovascular disease (CVD) risk in older populations. However, wine consumption information through self-reports is prone to measurement errors inherent to subjective assessments. The aim of this study was to evaluate the association between urinary tartaric acid, an objective biomarker of wine consumption, and the rate of a composite clinical CVD event.

Long-Term Decision Regret and Associated Factors Following Urinary Reconstruction in Underserved Patients with Spinal Cord Injury.

Purpose: Patients with refractory neurogenic bladder dysfunction may require urinary reconstruction due to severe incontinence, difficulty with catheterization, and to prevent upper urinary tract compromise. We evaluated long-term decisional regret and associated factors following urinary reconstruction in spinal cord injury patients.

Materials And Methods: We interviewed patients with spinal cord injuries who underwent bladder reconstruction surgery at least ten years ago, administering validated surveys on bowel quality of life and dysfunction, urinary tract infections, and decisional regret.

Maternal lipid mobilization is essential for embryonic development in the malaria vector Anopheles gambiae.

Lipid metabolism is an essential component in reproductive physiology. While lipid mobilization has been implicated in the growth of Plasmodium falciparum malaria parasites in their Anopheles vectors, the role of this process in the reproductive biology of these mosquitoes remains elusive. Here, we show that impairing lipolysis in Anopheles gambiae, the major malaria vector, leads to embryonic lethality.

Drinking pattern and time lag of alcohol consumption with colorectal cancer risk in US men and women.

Background: Association between light to moderate alcohol consumption and colorectal cancer (CRC) incidence remains understudied, especially regarding drinking pattern, beverage type and temporal aspects.

Methods: Hazard ratios (HRs) and 95% confidence intervals (CIs) for time to CRC diagnosis were estimated among 137,710 participants. Estimates based on remote (eg, >10 years before follow-up) and recent (eg, the preceding 10 years before follow-up) alcohol intake, using different cutoffs (eg, 8, 10, 12 years, etc) and mutual adjustment, enabled separating independent effects and investigating time lag of alcohol-CRC association.

Preliminary clinical performance of a Cas13a-based lateral flow assay for detecting in urine specimens.

Nucleic acid amplification testing (NAAT) for is unavailable in resource-limited settings. We previously developed a CRISPR-based lateral flow assay for detecting . We aimed to pair that assay with point-of-care DNA extraction, assess performance in clinical urine specimens, and optimize assay kinetics.

Integrated Analysis of Oral Microbiome and Metabolome in T2DM Patients With Varying Glycemic Status.

Objective: This study aimed to analyze the subgingival and salivary microbiome and metabolome in diabetic periodontitis patients with varying glycemic levels.

Methods: Forty-two diabetic periodontitis patients were sampled of saliva, gingival crevicular fluid (GCF), and blood, and categorized into three groups based on systemic glycemic status. The microbiome was assessed using full-length 16S rRNA gene sequencing.

Taiso practice and risk of functional disability and dementia among older adults in Japan: The JAGES cohort study.

Background: Taiso is a Japanese term encompassing meanings akin to calisthenics. Taiso is a widely used exercise program in Japan but whether it prevents functional disability and dementia remains unclear. This study aimed to elucidate the association between practicing Taiso, especially focusing on the well-known Radio-Taiso, and functional disability and dementia in older adults in Japan.

Recommendations for the optimal introduction of novel antibiotics to treat uncomplicated gonorrhoea in the face of increasing antimicrobial resistance: a case study with zoliflodacin.

New, first-in-class oral antibiotics like zoliflodacin, developed in a public-private partnership, require an optimal introduction strategy while ensuring antibiotic stewardship. Zoliflodacin, given as a single dose for uncomplicated urogenital gonorrhoea, recently demonstrated non-inferiority to ceftriaxone plus azithromycin and safety in a phase 3 randomised controlled trial. Following regulatory approval, zoliflodacin could improve sexually transmitted infection (STI) management and help address the threat of untreatable gonorrhoea, as levels of resistance to current first-line treatments increase.

Reach and impact of a nationwide media campaign in Ethiopia for promoting safe breastfeeding practices in the context of the COVID-19 pandemic.

Background: In response to the COVID-19 challenge and the consequent concerns and misconceptions about potential mother-to-child virus transmission, the United Nations Children's Fund (UNICEF), in collaboration with the Ethiopian Ministry of Health, launched a 3-month nationwide media campaign to promote appropriate and safe breastfeeding practices using national and regional television and radio channels, as well as social media. This study assesses the reach and impact of a media campaign in Ethiopia on improving mothers', partners'/caregivers', and the public's awareness of and practices related to appropriate and safe breastfeeding.

Methods: A two-round mobile survey was conducted using random digit dialing (RDD) and an interactive voice response (IVR) system.

Investigating inconsistencies regarding health equity in select World Health Organization texts: a critical discourse analysis of health promotion, social determinants of health, and urban health texts, 2008-2016.

Background: Scholarly critiques have demonstrated that the World Health Organization (WHO) approaches the concept of health equity inconsistently. For example, inconsistencies center around measuring health inequity across individuals versus groups; in approaches and goals sought in striving for health equity; and whether considerations around health equity prioritize socioeconomic status or also consider other social determinants of health. However, the significance of these contrasting approaches has yet to be assessed empirically.

Health promotion, the social determinants of health, and urban health: what does a critical discourse analysis of World Health Organization texts reveal about health equity?

Background: The World Health Organization (WHO) has focused on health equity as part of its mandate and broader agenda-consider for example, the "health for all" slogan. However, a recent scoping review determined that there are no studies that investigate the WHO's approach to health equity. Therefore, this study is the first such empirical analysis examining discourses of health equity in WHO texts concerning health promotion, the social determinants of health, and urban health.

Associations between phenotypes of childhood and adolescent obesity and incident hypertension in young adulthood.

Objectives: We investigated whether empirically derived childhood obesity phenotypes were differentially associated with risk of hypertension in young adulthood, and whether these associations differed by sex.

Methods: Data came from 11,404 participants in the Growing Up Today Study, a prospective cohort study in the US established in 1996. We used a childhood obesity phenotype variable that was previously empirically derived using latent class analysis.

Genomic and transmission dynamics of the 2024 Marburg Virus Outbreak in Rwanda.

The ongoing outbreak of Marburg virus disease (MVD) in Rwanda marks the third largest historically, though it has exhibited the lowest fatality rate. Genomic analysis of samples from 18 cases identified a lineage with limited internal diversity, closely related to a 2014 Ugandan case. Our findings suggest that the Rwandan lineage diverged decades ago from a common ancestor shared with diversity sampled from bats in Uganda.

Cannabidiol for Scan-Related Anxiety in Women With Advanced Breast Cancer: A Randomized Clinical Trial.

Importance: Early evidence from studies outside of oncology has suggested that cannabidiol (CBD) may have anxiolytic effects without neuropsychiatric risks. An understanding of oral CBD in patients with cancer-related anxiety is urgently needed.

Objective: To determine whether a single 400-mg oral dose of a US Food and Drug Administration-approved CBD improves clinical anxiety in an oncologic population.

Lithium Use During Pregnancy in 14 Countries.

Importance: In pregnancy, the benefits of lithium treatment for relapse prevention in psychiatric conditions must be weighed against potential teratogenic effects. Currently, there is a paucity of information on how and when lithium is used by pregnant women.

Objective: To examine lithium use in the perinatal period.

Robust Estimation of Loss-Based Measures of Model Performance under Covariate Shift.

We present methods for estimating loss-based measures of the performance of a prediction model in a target population that differs from the source population in which the model was developed, in settings where outcome and covariate data are available from the source population but only covariate data are available on a simple random sample from the target population. Prior work adjusting for differences between the two populations has used various weighting estimators with inverse odds or density ratio weights. Here, we develop more robust estimators for the target population risk (expected loss) that can be used with data-adaptive (e.

A Graduate Medical Education Fellowship in Climate Change and Human Health: Experience and Outcomes From the First 5 Years.

Climate change is affecting health and health care, but most physicians lack formal training on climate change. There is a need for graduate medical education (GME) programs that prepare physician leaders to address its health impacts. To describe the development and iterative piloting of a GME fellowship in climate change and health and to assess fellows' academic output and public engagement before and after fellowship matriculation.

Peritraumatic C-reactive protein levels predict pain outcomes following traumatic stress exposure in a sex-dependent manner.

Background: Chronic pain following traumatic stress exposure (TSE) is common. Increasing evidence suggests inflammatory/immune mechanisms are induced by TSE, play a key role in the recovery process versus development of post-TSE chronic pain, and are sex specific. In this study, we tested the hypothesis that the inflammatory marker C-reactive protein (CRP) is associated with chronic pain after TSE in a sex-specific manner.

Probability of vertical HIV transmission: A systematic review and meta-regression.

Background: Eliminating HIV vertical transmission (VT) and is a global priority. Estimates of paediatric HIV infections are commonly derived through mathematical models relying on rates of VT stratified by maternal immunological and treatment status from literature, namely the UNAIDS-supported Spectrum AIDS Impact Module (Spectrum-AIM) to assess progress towards eliminating VT. Default VT probabilities were last updated in 2018, since then there have been substantial changes to service delivery and ART regimens.